The End of the Antibiotics EraMay Be at Hand(Rise of the Superbugs)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

My generation of physicians was weaned on the romantic notion of how the introduction of Penicillin changed the entire world for the better. It was a true miracle, and it is very sobering to hear that this era will come to an end soon.

Penicillin was the original wonder drug and it changed the spectrum of disease and the world right along with it. Overnight, bacterial sore throats leading to heart damage and kidney failure disappeared. That kid in the western movies dying of scarlet fever was no more.

Antibiotics are everywhere today. It may surprise you to know that the largest users of routine antibiotics are in the food industry. All major producers of beef and poultry use them to keep the massive clusterings of livestock healthy for efficient and mass processing.

Sir Alexander Fleming himself, who discovered the drug, realized almost immediately that it needed to be used cautiously and observed that some bacteria appeared to be resistant to its effects.

Antibiotic resistance is a very real entity and should worry all of us. It is an abstract concept, as any statistical entity becomes, and some try to personalize it in order to understand the problem.

Basically, when you destroy a large portion of susceptible bacteria, the ones that by shear chance were able to survive multiply the most. This effect can be magnified with messenger packets of information that bacteria can exchange with each other.

There are in existence today at least four types of bacteria which cause illness and death in humans and for which no known antibiotic works. It is perplexing doctors across the continent who must stand by and watch patients fight these infections with nothing more than their own immune systems and often losing this battle.

Throughout my entire career, it seems that medicine is always chasing that resistant bug by developing new and more powerful antibiotics. This pipeline is rusting and empty now. The major pharmaceutical companies have stopped all their research and development in this field. Any drug that loses effectiveness within years of development is of little business interest. We are faced with the stark realization that there are no new antibiotics in development today.

Modern hospitals are cautiously guarding the newest drugs and releasing them only in special circumstances in the hope that we can extend their effectiveness. These superbugs were once thought to cluster in hospitals, but it is now felt that they are also in the community. The one good thing is that our own immune systems are also watching and reacting to these bacteria, and just as they evolve, our own systems learn to recognize and destroy them.

It is perhaps a defining moment in my career to realize that history is on the brink of recording the end of the antibiotic era. The trend is near impossible to reverse. New methods of treatment partnering with our own immune systems will hopefully emerge.

● Are you ready for a world without antibiotics? By Sarah Boseley, The Guardian.
Antibiotics are a bedrock of modern medicine. But in the very near future, we're going to have to learn to live without them once again. And it's going to get nasty.

● Rise of the Superbugs - Trailer. YouTube video, 2:21 min. " Published on Nov 21, 2012: The nightmare is here. Rampant use of antibiotics coupled with an explosion in global travel has led to superbugs spreading worldwide. Join us as we step into the lab with leading experts on antibiotic resistance, and listen to shocking stories of the health implications. Let's face up to the horror of antibiotic resistance before it's too late..."

● Documentary: Rise of the Superbugs by Dr. Mercola. Video 42:56 min. "Antibiotic overuse is a major threat to public health, and after watching the documentary Rise of the Superbugs, you'll understand exactly why.

Diseases that were deadly prior to the invention of modern-day antibiotics are now coming back with a vengeance, having developed resistance to these once foolproof treatments.

First it was MRSA (methicillin-resistant Staphylococcus aureus), once rare but now far too commonplace in medical settings, but now antibiotic-resistant bacterial infections like multidrug-resistant tuberculosis (TB), meningitis and others are spreading around the globe.

Antibiotic overuse is rampant all over the world, including in India where antibiotics are available for low cost and without a prescription. There, it's estimated that more than half of bacterial infections in Indian hospitals are resistant to commonly used antibiotics, and many are also resistant to the more powerful, broad-spectrum antibiotics.

A growing number of infections, however, now carry a gene called "New Delhi metallo-beta-lactamase 1," or NDM-1 that confers 'super resistance' to conventional antibiotics.

Resistant to carbapenems, powerful "last-resort" intravenous antibiotics as well as at least 14 other antibiotics, NDM-1 is virtually unstoppable ... and it's not staying in India, either.

Already, NDM-1 bacteria have been found in drinking water around New Delhi and in patients in over 35 countries, many of them 'medical tourists' who traveled to India for medical care then returned home to Europe, the Middle East and the Americas. ..."

● Antibiotics: End of An Era? By Stephanie Smith, Null Hypothesis: The Journal of Unlikely Science. "When Alexander Fleming discovered the first antibiotic in 1928, it was heralded as a medical miracle. However, as early as the 1940s, only a few years after the first mass production of penicillin, the bacteria it was supposed to be fighting had already started to evolve resistance to the wonder drug, beating us at our own game."